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NPI Code Detail

MEDICARE: JAMES WILLOUGHBY DAME BC-HIS

MEDICARE: JAMES WILLOUGHBY DAME BC-HIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1237700000XHearing Instrument SpecialistAS1565FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003846528
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES WILLOUGHBY DAME BC-HIS
Provider Business Mailing Address
First Line : 2232 SAINT ANDREWS BLVD
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-2158
Country : US
Telephone Number : 850-784-4327
Fax Number : 850-784-0060
Provider Business Practice Location Address
First Line : 2232 SAINT ANDREWS BLVD
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-2158
Country : US
Telephone Number : 850-784-4327
Fax Number : 850-784-0060
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2006
Last Update Date : 07/09/2007

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Directions to “ JAMES WILLOUGHBY DAME BC-HIS” Practice Location

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